Abstract
BackgroundThe provision of affordable and reliable daycare services is a potentially important policy lever for empowering Indian women. Access to daycare might reduce barriers to labor force entry and generate economic opportunities for women, improve education for girls caring for younger siblings, and promote nutrition and learning among children. However, empirical evidence concerning the effects of daycare programs in low-and-middle-income countries is scarce. This cluster-randomized trial will estimate the effect of a community-based daycare program on health and economic well-being over the life-course among women and children living in rural Rajasthan, India.MethodsThis three-year study takes place in rural communities from five blocks in the Udaipur District of rural Rajasthan. The intervention is the introduction of a full-time, affordable, community-based daycare program. At baseline, 3177 mothers with age eligible children living in 160 village hamlets were surveyed. After the baseline, these hamlets were randomized to the intervention or control groups and respondents will be interviewed on two more occasions. Primary social and economic outcomes include women’s economic status and economic opportunity, women’s empowerment, and children’s educational attainment. Primary health outcomes include women’s mental health, as well as children’s nutritional status.DiscussionThis interdisciplinary research initiative will provide rigorous evidence concerning the effects of daycare in lower-income settings. In doing so it will address an important research gap and has the potential to inform policies for improving the daycare system in India in ways that promote health and economic well-being.Trial registration(1) The ISRCTN clinical trial registry (ISRCTN45369145), http://www.isrctn.com/ISRCTN45369145, registered on May 16, 2016 and (2) The American Economic Association’s registry for randomized controlled trials (AEARCTR-0000774), http://www.socialscienceregistry.org/trials/774, registered on July 15, 2015
Highlights
The provision of affordable and reliable daycare services is a potentially important policy lever for empowering Indian women
This paper presents the protocol for a cluster-randomized trial, named the Uttam Unnati, or “great progress” study, which aims to address this research gap by evaluating the effect of a community-based daycare program on health and socioeconomic status among women and children living in rural Rajasthan, India
This paper provides the protocol for a cluster-randomized evaluation of the impact of access to affordable daycare on social, economic, and health outcomes of rural Indian women and their children
Summary
Study design This is a three-year cluster-randomized trial that examines the effects of introducing an affordable daycare program on health and economic well-being over the life-course. Participants and village hamlets In December 2014 and early January 2015, 160 hamlets were selected from five blocks (i.e., Badgaon, Girwa, Jhadol, Kherwara, Kotra) in the Udaipur District where Seva Mandir had not previously established balwadis (Fig. 3) These hamlets satisfied five criteria determined a priori, : (1) no readily accessible daycare within 1.5 kilometers to reduce the potential for contamination effects; (2) a minimum number of children (≥25) in the appropriate age range in the hamlet to ensure adequate demand; (3) an existing structure suitable for a daycare; (4) a qualified woman, living in the study hamlet or nearby, to operate the daycare; and (5) adequate demand from the village council (Panchayat) for a new daycare. Trial status At the time of submission the intervention had been introduced in treatment areas and data collection as part of the mid-line survey was being planned
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